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Pleural effusion is not always visible as a meniscus in the costophrenic angle. 
A subpulmonic effusion
Pleural effusion ... with signs of CHF ... #Clinical #Radiology ... #CXR #CHF #Pleural ... SubpulmonicEffusion #RadiologyAssistant
Pleural effusion is bilateral in 70% of cases of CHF.
When unilateral, it is slightly more often
Pleural effusion ... 70% of cases of CHF ... #Clinical #Radiology ... #CXR #CHF #Pleural ... #RadiologyAssistant
Here are the most common examples of these four patterns on a chest x-ray (click image
consolidation - Multifocal ill-defined ... Diagnosis #Clinical #Radiology ... #CXR #Consolidation ... #Patterns #RadiologyAssistant
On the left another patient with a large cardiac silhouette on the chest x-ray due to
to pericardial effusion ... Pericardial effusion ... CT-reconstruction #Clinical #Radiology ... #CXR #CTChest # ... PericardialEffusion #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
adenopathy and pleural effusion ... low attenuation areas ... #Clinical #Radiology ... Comparison #Table #RadiologyAssistant
Congestive heart failure
The findings are:
 - bilateral perihilar consolidation with air bronchograms and ill-defined borders
 -
bronchograms and ill-defined ... like to look at old ... #Clinical #Radiology ... #CXR #CHF #RadiologyAssistant
#Clinical #Radiology #CXR #Opacification #Air #Bronchogram #AirBronchogram #PleuritisCarcinomatosa #Carcinomatosa #Effusion #RadiologyAssistant
#Clinical #Radiology ... #CXR #Opacification ... Carcinomatosa #Effusion ... #RadiologyAssistant
On the left a patient with CHF. 
There is an increase in heart size compared to
a patient with CHF ... compared to the old ... #Clinical #Radiology ... #CXR #CHF #Exacerbation ... #Comparison #RadiologyAssistant
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
comparison with old ... during a period of CHF ... #Clinical #Radiology ... #CXR #CHF #Cephalization ... Redistribution #RadiologyAssistant
Cardiac incisura
Click image to enlarge.
On the right side of the chest the lung will lie against
pericardial fat or effusion ... #Clinical #Radiology ... #CXR #Lateral # ... Cardiac #Incisura #RadiologyAssistant